Forensic pathologists in Ontario are part of a team of public servants responsible for conducting investigations into criminally-suspicious deaths. Forensic pathologists perform autopsies, determine the cause and manner of death for a victim, and document the victim’s injuries; this is quite important for the prosecution of criminally-suspicious deaths such as sexual femicides. The impact of biases on forensic pathologists’ decision-making processes and their ability to maintain objectivity has been a topic of discussion amongst scholars and lawmakers in recent years; however, there has yet to be a North American study examining the role of bias in forensic pathologists’ decision-making. Using a mixed methods study design, 10 Category A forensic pathologists were surveyed and six were interviewed. The surveys focused primarily on identifying factors that impact forensic pathologists’ decision-making in cases of actual or suspected sexual homicide, while the interviews examined forensic pathologists’ processes for conducting an autopsy and sexual assault exam, the information they typically receive about a case, and their knowledge of and engagement with feminist issues. Several factors (a combination of victim-, offender-, and case-related information) were identified as significantly impactful to forensic pathologists’ decision-making processes. Despite participants’ assertion that objectivity is of the utmost importance to their work, several instances of subjective or biased decision-making were identified and subsequently examined. Future research on the subject should examine the case information forensic pathologists receive from police officers, coroners, and community members, and the impact of those actors’ biases on the information they communicate to forensic pathologists.